Will there be Tents erected on site? (Note: Any tent or air supported structure in excess of 200 square feet (net) will require its own Mandatory Operational Permit)

Yes

No

Restroom Facilities*

Will you be providing additional (portable) restroom facilities?

Yes

No

Trash and Recycling Facilities*

Will you be providing extra trash and recycling facilities throughout the site?

Yes

No

Crowd Management Certification

Please Note: If expected attendance of the event is greater than 1000 people, please provide Crowd Management Certification information and Public Safety Plan (per 403.2.1 of the North Carolina State Fire Prevention Code):

Required Information for Crowd Management Certification (CMC)

* Parking and Traffic Flow; including streets to be closed or obstructed; any barriers or traffic control devices that will be erected. * Pedestrian access and flow. * The location of any concession stand(s), booth(s) or other temporary structures or facilities; and the location of proposed fences, stands, benches, or bleachers.

On-Site Watch Personnel (if applicable)

Please List any and all watch personnel that will be in charge of Fire Watch and Security Protection.

Sketches, Maps, Site Plans and Drawings*

Please upload any and all pertinent files of Sketches, Maps, Site Plans, Evacuation Routes and Drawings showing the location of equipment and/or the operation in its entirety.

Event Plan

Application Agreement

Permit Fee: $100.00

Payment

Payments are required to be paid in full prior to the issuance of the Permits, and can be made by Check, Cashier's/Banker's Check, Money Order or Credit/Debit Card Payment** at the Kinston Department of Fire and Rescue (Headquarters) Station 1, 401 E Vernon Avenue, Kinston, North Carolina 28501, during business hours, or by mailing or delivering a Check, Cashier's/Banker's Check or Money Order made out to the City of Kinston in care of the Kinston Department of Fire and Rescue at P. O. Drawer 339, Kinston, North Carolina 28502.
** (Conditions of Credit/Debit Card Payment can be made over the phone with the Administration Assistant of the Kinston Department of Fire and Rescue by calling 252-939-3164)

Date and Time of Payment Instructions*

Date and Time of Payment Instructions

Date and Time of Payment Instructions

By marking the date and time that the instructions have been read, Applicant is agreeing to contacting the Administration Assistant to schedule and make the payment prior to issuance of the Permit.

Waiver of Hold Harmless and Release

I, the applicant, agree to indemnify and hold harmless the City of Kinston, its employees, and its agents from and against any and all liablility for any injury which may be suffered in connection with this Permit being requested. I also hold harmless the City of Kinston, its employees, and its agents from and against any liability for any equipment or supplies lost, stolen or damaged, that are stored or otherwise as a result of this Permit being requested.

Date and time of the Waiver of Hold Harmless and Release*

Date and time of the Waiver of Hold Harmless and Release

Date and time of the Waiver of Hold Harmless and Release

This Waiver of Hold Harmless and Release has been read, agreed to and will be kept by me starting at this date and time that it was read and understood.

The Undersigned hereby makes application for a permit and the inspection of all work described above and hereby agrees to comply with all regulations and other Laws applicable to the use and type of work being performed.

Electronic Signature Agreement*

By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.